An echocardiogram (echo) is a non-invasive medical test that uses high-frequency sound waves to create moving pictures of your heart. This ultrasound allows physicians to assess the heart’s structure, check the function of its chambers and valves, and monitor blood flow dynamics.
The Direct Answer and Rationale
Yes, you must remove your bra and any clothing covering the chest area for an echocardiogram. This requirement is purely technical, driven by the physics of ultrasound imaging. The procedure uses a handheld device called a transducer, which must be placed directly against the skin to transmit and receive the necessary sound waves.
The transducer is moved across the chest wall to capture images of the heart from multiple angles, including spots along the breastbone, under the ribs, and sometimes near the collarbone. Any layer of fabric, especially thick material or underwire, creates an air gap between the skin and the transducer. This interference can scatter the sound waves, resulting in poor image quality that makes it difficult to obtain a clear, diagnostic view of the heart structures. To ensure sound waves travel cleanly, a specialized gel is applied to the skin, acting as a contact medium to eliminate air pockets, which clothing would complicate.
What to Expect During the Procedure
Once you are in the examination room, you will be asked to undress from the waist up and change into a hospital gown. The gown is typically worn with the opening in the front to allow easy access to the chest while maintaining modesty. You will then lie down on an examination table, often on your left side, which helps bring the heart closer to the chest wall for clearer imaging.
A cardiac sonographer will apply a cool, water-soluble gel to your chest. They will then press the transducer firmly against your skin and move it around to capture the required views of your heart. Throughout the process, the sonographer will work to ensure your privacy, often using towels or blankets to drape and cover the areas of your chest that are not actively being scanned. The sonographer may ask you to hold your breath for a few seconds or change positions slightly to improve the image quality by moving the lungs out of the way. The entire procedure is painless and usually takes between 30 and 60 minutes to complete.
Preparing for Your Appointment
Minimal preparation is needed for a standard transthoracic echocardiogram, but a few simple steps can make the experience smoother. Since you will change into a gown, wearing comfortable, two-piece clothing that is easy to remove is advisable for quick changing before and after the scan.
It is important to avoid applying any lotions, oils, or powders to your chest area on the day of the test. These products can interfere with the sticky electrodes used to monitor your heart’s electrical activity and the adherence of the ultrasound gel. You should also remove any necklaces or long pendant jewelry before the appointment, as these items will be in the way of the scanning area. Generally, you can eat, drink, and take your medications as you normally would before the test.